Patients' rights gap appears to be narrowing

Associated Press

Published Wednesday, August 01, 2001

WASHINGTON -- Negotiating late into the night, the White House and a key rebel Republican lawmaker grew close to an agreement on patients' rights legislation that President Bush would be willing to sign.

Two administration officials, speaking on condition of anonymity, said they came to terms after midnight with aides for Rep. Charles Norwood of Georgia on a key issue: the venue for HMO appeals. The appeals would be apportioned between state and federal courts, the sources said without providing further details.

Norwood was taking the proposal Tuesday to allies, including Sen. John McCain, R-Ariz., and Edward M. Kennedy, D-Mass., and Rep. John Dingell, D-Mich. Their approval is critical to a successful compromise.

Administration officials said Kennedy and McCain already were ''part of the solution.''

White House and Norwood aides entered into a bill-drafting session late Monday after Bush called the Republican and urged him to align himself with the White House on the issue and not with the Democrats.

''We are very close to a deal,'' Norwood spokesman John Stone said Monday.

He refused comment on Bush's telephone call to Norwood but said the congressman is committed to staying with bipartisan supporters of the bill, meaning Democrats who have shied away from compromises suggested by the White House.

Bush has promised to veto the current version of protections for patients in HMOs and other health plans. Its sponsors include Dingell, Kennedy and McCain.

Administration officials claimed they had made gains in the New Jersey delegation, putting them close to securing enough votes to pass an alternative to the Democratic-backed bill. The administration made headway, aides say, after invited New Jersey doctors to a White House briefing in the presence of wavering New Jersey lawmakers.

The showdown on patients' rights legislation loomed Tuesday as House Majority Leader Dick Armey prepared to go on the offensive against the plan, which is overwhelmingly backed by Democrats.

In a speech to the Cato Institute, a libertarian think tank, Armey, a Texas Republican, was to criticize the version as too costly because it encourages wronged patients to sue health plans instead of finding other ways to get insurers to pay for needed care. He also said patients should be able to use tax-free accounts and other methods of meeting their health costs.

''Yes, patients should be able to sue their HMO,'' Armey said. ''But even more, they should be able to fire their HMO. This is America. Patients should have the right and the ability to take their business elsewhere.''

House Speaker Dennis Hastert, who talked with Norwood on Monday, said the congressman asked him for a specific date when the issue would come up for a vote. Hastert, R-Ill., said he told Norwood he was ready to bring the bill up quickly if an agreement could be reached with the president. ''I said if he's ready to go this week, I'll go this week,'' Hastert said.

Rep. James Saxton, R-N.J., was among those who met Monday at the White House in the latest round of talks. Saxton said possible additional federal health payments to New Jersey hospitals with high caseloads of low-income patients did not come up but may be part of final negotiations on the legislation.

Republican sources familiar with Bush's call to Norwood, speaking on condition of anonymity, said the president pressed the congressman in highly personal terms to support the White House's bid to rewrite the legislation so Republicans could support it.

Stone would not discuss negotiation details but said Norwood is seeking a bill that everyone can agree on and that Bush will sign.

''We feel we're closer to that than any time before, thanks to the good-faith efforts of the president,'' he said.

The measure is designed to provide patients new rights in dealing with HMOs and other insurance companies, including better access to emergency room care and treatment by medical specialists. While broad agreement exists on types of patient protections to be included, disagreements come in over the extent to which patients should be permitted to sue HMOs and the size of damages for which insurers should be liable.

Norwood and most Democrats favor a bill with broader access to courts, including state courts, where trial lawyers feel such cases are more likely to prevail. They say the right to sue is essential if the new protections are to be meaningful.

Bush and most Republicans prefer to send most suits to federal courts and to limit damages. They say patients worry more about getting treatment than filing suits. And because the Democratic bill would make insurance more costly, they say, some people would lose coverage.